b'It is present in up to 6.4 percent of peoplespasticity can be described as a cramping or with MS. This pain is described as lancinatingpulling sensation. It can be worse at nighttime or shock-like pain. The pain can occuror in extreme temperatures. If the spasticity spontaneouslyorbetriggeredbyexternalbecomessevereandcausescontractures, stimuli such as touching the face, talking, orpain may be generated from the actual joint. brushing teeth. The attacks of pain can lastThis is worsened by moving the joint.from a few seconds to several minutes. ThisM ain sMiixxeeddppain syynnddrroommeeiinnMMSSpain syndrome is due to a demyelinatingHeadaches occur as a result of neuropathic lesion in the brainstem in the area where theand nociceptive causes. Headaches have been trigeminal nerve exits.reported in up to 50 percent of people with WWhhaattiissnnoocciicceeppttiivveeppaaiinn?? MS. Migraine is a result of activation of nerve Nociceptive pain is caused by damage totransmission and dilation of blood vessels. body tissues by physical trauma or injury. It isMigraine headaches can be the result of oftenreferredtoasmusculoskeletalpain.demyelinating lesions within the brainstem Nociceptivepaincanbesharp,aching,orwhere migraines are generated from. Migraines throbbing. If you have ever broken a bone orare often present at the time of diagnosis. cutyournger,youhavefeltnociceptiveMigraine headaches can be throbbing or pain. In MS, this type of pain can result frompulsating. Theyaremoderatetoseverein musculoskeletalissuessuchasmuscleseverity, and are associated with nausea, and weakness,spasticity,andmusclespasms.light or noise sensitivity. Migraines can occur This type of pain is not directly the result ofwith or without visual changes called auras. demyelinating lesions but is secondary to theTension-type headaches also occur in people effects of MS. with MS. This headache is a milder headache Lower back pain is the most commoncompared to migraines. It is described as a nociceptive pain syndrome. It occurs in up topressure, tightening, or band-like sensation. 20 percent of people with MS. Lower backItisnotassociatedwithnauseaorauras. pain is the result of abnormal posture becauseThese headaches may be because of increased of muscle weakness and spasticity. Havingtension in the muscles of the head.weakness in one leg results in asymmetricCCoonncclluussiioonnposture and poor movement. These arePain does, indeed, exist in patients with MS. predisposing factors for back pain. SpasticityHowever, the type and severity of the pain and contractures can also contribute to lowermay differ. There are many types of pain that are back pain. The pain is generated from theprimarily due to the inammatory process of MS, muscles and joints. and secondary to the effects of MS. Although Spasticity, including muscle spasms, causesthese are the more common pain syndromes pain in up to 15 percent of people with MS.associated with MS, you may experience other Spasticity is an abnormal increase in musclepain syndromes. It is important to know what tone. In severe cases it can result in contracturestype of pain you may be experiencing. This (a permanent tightening of the muscles, tendons,will help you and your provider to discuss or ligaments that locks a joint, preventing itanddeterminetheappropriatetreatment from moving freely). The pain associated withand management for you.15 msfocusmagazine.org'